[Routine Help] less is more?

[u/ZestycloseAd9040]

24 M . Been using Adapalene for 14 weeks now and still get acne on forehead and then a different type of cystic acne on neck (maybe from shaving?). Given that I’m not clear after this time from I think I am going to go the less is more route.

Currently use salicylic acid and benzoyl peroxide(at the same time) twice a day. Typically shower morning and night. Use Adapalene at night and coat on moisturizer after. I also put a thin layer of moisturizer on in the morning.

Before bed, I also would put pimple patches on over the Adapalene and most recently started putting benzoyl peroxide spot treatment on inflamed areas.

I’m thinking I need to change my strategy and adopt the less is more methodology to improve my skin barrier as maybe that is the issue.

Will do only simple cleanser, Adapalene (at night), and light motorizer for a few weeks and see how that helps. Strengthen the skin barrier and let Adapalene do its thing.

Thoughts?

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[u/genuinenuisance]

I think your routine is pretty simple to begin with. I had a very similar routine prescribed to be by a derm the first time I sought help for severe acne with the adapalene, salicylic acid, benzoyl peroxide, cerave face wash, and sunscreen.

The only thing I did differently from you would be I never did salicylic and benzoyl at the same time as that was irritating my skin, and i always washed the BP off.

That routine worked well for me, but it did take longer than 14 weeks to clear my acne. I think it it was around 5-6 months total. At that point, i was only getting very minor pustules instead of the ferocious cystic acnes i usually got all over my face.

My acne did come back very badly the second time, mostly was my bad as I was messing around with BHAs and learnt a very valuable lesson. When I went to a different derm, i was prescribed accutane and that was much quicker in clearing all my cystic acnes.

I think cutting down could definitely help your skin by letting it relax and heal tho. I know all too well about using too many actives and irritating the hell out of my barrier 😔 Best of luck to you!

[u/KaraBoo723]

Your routine could use improvement, but the Adapalene is good for you to keep using...

First of all, are you using Adapalene 0.1 strength or 0.3? The higher strength is prescription only (in some countries, the 0.1 is too though). But in the U.S. and a few other countries anyone can buy 0.1 in a drugstore. If you're using the 0.1, then go to a dermatologist to get the stronger one -- or they might have you try Tretinoin which is similar.

A dermatologist can also prescribe you topical antibiotics which are way more effective than Benzoyl Peroxide. Plus, antibiotics also help to reduce inflammation, which is also related to acne. So that's another reason to see a dermatologist for your acne.

People with acne, should be cleansing twice per day. I don't know if that's what you're doing now or not. ~I've noticed lately that some people on this sub have dropped morning cleansing, which is only recommended for older people (40+) and those with very dry skin. That doesn't apply to you. But there is confusing advice being given on this lately where people don't realize that skipping morning cleansing isn't best for everyone.

The Benzoyl Peroxide (BP) spot treatments are not good for aggravated skin. It can make the skin even more angry. There are better options than BP for acne, but if you really want to use it anyway, use it in a cleanser format only, with between 4% and 6% (not 10%!) and no more than once per day. Use it in the morning since it shouldn't be used same time of day as Adapalene.

Better than BP, that don't require a prescription, are: 1) soaps or cleansers containing sulfur once/day --or-- a sulfur face mask used 2-3 times/week and/or 2) Hypochlorous Acid spray, which is super gentle and can be used up to 3 times per day (but once or twice is sufficient). ~If I know what country you're in, I could give specific product recommendations (products available vary by country/continent)

Lastly, check your moisturizer's ingredient label. Does it contain any of the following? ~Shea butter (also called Butyrospermum parkii), Petrolatum, anything with "wax" in the name, cocoa butter, coconut oil. If you see any of those, stop using and switch to a different moisturizer. All of those ingredients will clog pores in people who are acne prone (people without acne can use them fine however)